Inspection on 16/09/05 for Durrants Care Services Ltd

This inspection was carried out on 16th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Durrants Care Services Ltd 24/10/08

Durrants Care Services Ltd 25/10/06

Durrants Care Services Ltd 10/03/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Durrant Care Services Durrants Court Barn Ashford High Halden TN26 3BS Lead Inspector Sally Gill Announced 16/09/05 at 09:30hrs The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Durrant Care Services Ltd Address Durrants Court Barn Asford Road High Halden Kent TN26 3BS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01233 850014 01580761128 joe.durrants@virgin.net Mr Joseph Graham Mr Joseph Graham Registered Care Home 2 Category(ies) of Adults with a Learning Disability 18-65 registration, with number of places Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Services Users to be restricted to two (2) whose DOB are 04/01/1957 and 06/11/1967 (with effect from 28/08/04) Date of last inspection 29th March 2005 Brief Description of the Service: Durrants Court Barn Annex is registered to provide accommodation for 2 named adults with a mild learning disability. The company Durrant Care Service owns the business. The Registered Manager, Mr Joe Graham has dayto-day responsibility for the Home. The premise is an annex of a converted barn with accommodation on the ground floor. The self-contained accommodation comprises of a double bedroom with ensuite shower and toilet and a lounge/diner with kitchenette. There is a decking area, outside which leads to the garden, which is shared with the main house. The Home is situated on the main A28 in the village of High Halden. Within the village there is a pub, church, post office and village shop. The town of Tenterden is approximately two miles away. The Home is on the bus route to both Tenterden and Ashford. The Home also has transport, which can be used for Service Users if they wish. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place on Friday, 16th September 2005 between 9.25am and 2.05pm. Additional time was spent in preparation and report writing. During the inspection the Inspector spoke to both Service Users together. Also, she spoke to the Registered Manager and met the only employed support worker and a volunteer briefly. Surveys were received back from all both Service Users and two relatives, which indicated that they are fully satisfied with their care at Durrant Court Barn Annex. The care of both Service Users was case tracked. The Inspector examined various records including care plans, risk assessments, client’s finances, the fire safety logbook, Medication Administration Record (MAR) charts and accident book. A part tour of the building was undertaken including the lounge/diner, kitchenette and shower/toilet. What the service does well: The service is tailored to meet the needs of the two Service Users both as individuals and as a couple. The home provides an attractive, comfortable, clean and homely environment. The manager and only staff member are committed to providing a quality of life for both Service Users and continue to improve that quality wherever possible. Service Users appreciate the manager’s availability to them, stating “Joe looks after us well”, “we tell Joe and he sorts it out”. Service Users spoke positively about the food, which in the main is supplied by the main house with comments such as “they are both good cooks”. Service Users are supported and talked about developing their life skills with consistent opportunities to practice them including cooking, cleaning and independent travel. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 6 Service Users have lots of opportunities to develop and maintain friendships and relationships. Access to specialist professionals such as the psychotherapist to aid development is facilitated. Service Users are supported to go to college/adult education. Links and opportunities to get out in the community and experience interesting activities such as bowling, swimming and horse riding take place regularly and are enjoyed by Service Users. Service Users are fully involved in the running of the home and say they are consulted about changes and help to plan holidays and day trips etc. What has improved since the last inspection? What they could do better: Improvements to the system for self-administration of medication are required to ensure Service Users safety. Care plans should cover all areas of standard 2.3 in sufficient detail; contain any restrictions of freedom and choice, a record of goals and evidence Service User involvement to ensure that their needs can be met. Risk assessments should contain sufficient detail to actually minimise the risk to Service Users and are clear as to who is responsible for actions (Service User/staff). Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 7 Service Users agreements must be agreed and signed by them. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 5. The homes Statement of Purpose and Service User Guide provide Service Users with the information they need to make an informed decision about the services the home provides. Service Users individual aspirations and needs have been assessed. Service Users individual written contract are not evidenced as agreed with Service Users. EVIDENCE: The home has produced a detailed Statement of Purpose and Service User Guide. Service Users have received a copy of the Service User Guide. A copy of the assessments and care plans undertaken by Care Managers were seen held on individual files. Individual written contracts were seen on files however these were not still not evidenced as agreed which is outstanding from the previous inspection. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9. Care plans do not contain sufficient detail to ensure all Service Users assessed needs; aspirations and goals can be met. The ethos of the home promotes Service Users to make responsible decisions. Service Users consultation takes place for all matters affecting the home. Records to support Service Users taking risks should be improved to ensure Service Users safety. EVIDENCE: Although the Inspector has no doubt that care needs are being met the paperwork to evidence this is poor. There is no change to the care plans since the last inspection. They do not cover all areas of standard 2.3 and the areas that are covered are not in sufficient enough detail to enable needs to be met. They do not evidence Service User involvement. Restrictions on freedom and choice are in line with a duty of care however are not recorded and should also be evidenced as agreed. Goal planning documents are not evidenced as reviewed and there is no detail as to how goals will be achieved. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 11 Service Users made it clear that they are fully consulted about any changes planned and have daily discussions with staff as well as weekly meetings. Staff support Service Users to manage their day-to-day affairs and chores but the emphasis is on the individuals taking responsibility. Risk assessments again have not been improved since the last inspection. They must contain sufficient detail to actually minimise the risk and are clear as to who is responsible for the actions (Service User/staff). Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17. Service Users have opportunities for personal development. Service Users are able to choose a variety of appropriate activities and leisure activities and get out into the wider community. Family and friends contact is well supported. Services Users rights are respected. Service Users enjoy a variety of meals. EVIDENCE: Service Users told the Inspector that they have the opportunity for personal development including cooking, cleaning, budgeting and independent travel. A rota of chores has been agreed and drawn up. A wide variety of activities are enjoyed by the Service Users including horse riding, horticulture, swimming and bowling. They also belong to various clubs within the community and attend college/adult education. The Service Users have enjoyed both a holiday and day trips this summer. Friendships made at their previous home are maintained. There is good family contact with both telephone calls and visits. All feedback from relatives was very positive. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 13 Service Users told the Inspector that they get their own breakfast, which twice a week is cooked. They are also supported to cook the main meal at least once a week. Otherwise the meals, which are “very good”, come from the main house. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. Personal support is provided in the way individual prefer and require it. Access to health care professionals is well supported. Service Users manage their own medication but shortfalls make the system not as safe as it could be. EVIDENCE: Service Users discussed where they go for clothes shopping and where they have their haircut. Service Users are able to undertake their own personal care. Discussions highlighted that times for getting up and going to bed are flexible and their choice. Records and discussions confirmed that Service Users have access to regular health checks including dentist, optician, chiropodist and doctor. It was evident that any problems are monitored and referred appropriately. Service Users are supported to attend hospital appointments. Only one Service User is currently on medication. All medication should be reviewed to ensure that it is still relevant and appropriately prescribed. Where this is not the case it should be referred back to the doctor. The MAR chart must reflect the full current medication accurately. Where a course of treatment has been completed the medication prescribed and no longer required should be returned to the pharmacist. Within the care plan there Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 15 should be a full record of all medication including start date, stopped dates and dosage. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Service Users feel they are listened to and indicated they feel safe in the home. EVIDENCE: There have been no complaints in the last twelve months any grumbles are dealt with at an early stage. Service Users confirmed that they feel able to complain and “Joe always sorts it out”. An adult abuse guidance policy is in place previously seen by the Inspector. Service Users are supported with the management of their personal allowances. The Inspector viewed the records, which are maintained appropriately. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27, 28 and 30. The home is attractive, comfortable and safe with a homely atmosphere. There is sufficient bathrooms/toilets and shared space. The home was clean and hygienic. EVIDENCE: The Home is registered to provide accommodation for the two named existing Service Users. The Annex is a self-contained unit, which fully meets the needs of the Service Users and is part of a converted barn in which the Registered Manager lives. The premise is in keeping with neighbouring properties. It provides a spacious, attractive, comfortable and well-maintained homely environment for the Service Users. With good standards of cleanliness and décor seen during the inspection. Furnishing and fitting are domestic in style and are of good quality. All fire equipment is tested regularly. The Annex has a shower/toilet, lounge/diner and also a kitchenette. The rooms were personalised by the many knick-knacks and other personal items displayed. The kitchenette houses a hob, sink and units, which meet the Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 18 needs of the Service Users. Meals are taken at the dining table situated in the lounge. There are no laundry facilities. Outside there is a decked patio area, which leads to the main garden, which is shared with the main house. The home is non-smoking and neither Service User smokes. The premise on the day of the inspection was clean, hygienic and free from offensive odours. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35 and 36. Service Users benefit from a competent and committed staff team who are clear about their roles and responsibilities and are deployed in sufficient numbers to meet the needs of the Service Users. EVIDENCE: Apart from the Registered Manager there is only one other member of staff who also lives within the main house. Staff of the Leo Trust Home can be used to transport the Service Users and usually at the same time as their own Service Users. The Inspector was advised that a volunteer is also used. Since the introduction of the NMS no new staff have been employed by the Home. The only staff member is a trained nurse and has undertaken food hygiene training, first aid course and fire safety. The member of staff has previously demonstrated that they had the skills and experience to meet the needs of the Service Users and have a good understanding of the Service Users needs and are committed to their development and to ensure that they had as much independence as possible. The member of staff has years of experience within both social care and previously nursing. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 20 The Inspector is aware that all support and supervision is provided informally on a day-to-day basis. Because of the busy lives of the Service Users and the fact that both spend so much time away from the Home either at college or a day care facility although the number of staff is low the Inspector feels that the needs of the Service Users are met albeit with some help in the form of transport from the Leo Trust Home and volunteers. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 41 and 42. The home is well run in an inclusive manner. The ethos of the home is very open, positive but supportive and encouraging the development of the Service Users. Quality assurance measures are in place but could be improved. Records are kept safe but need improvement to evidence Service Users needs are fully met and risk strategies are appropriate. The home is a safe environment. EVIDENCE: The Inspector viewed the Fire Safety logbook, which shows that all tests are carried out within timescales. The Registered Manager has a qualification in Social Work with forty years experience within care twenty-four of which have been with this client group. He is also currently the Registered Manager of a Leo Trust Home. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 22 Service Users confirmed that the Registered Manager and staff up hold the aims of Durrant Court Barn Annex and it is evident that they cascade this down to their day-to-day working within the Home. It is apparent that the running of the Home is a joint effort between the Registered Manager and his member of staff. The Home appeared on the day of the inspection to continue to be totally centred on the Service Users needs, well run with an open, relaxed and positive atmosphere. There is currently no formal quality assurance tool and all feedback is ongoing having developed good relationships with families and professionals involved in the home. Regular house meetings with minutes take place. From discussions with the Service Users it is apparent that they are fully satisfied with their Home. Both Service Users were aware of the announced inspection. See standard 9 for recommendations regarding the review of risk assessments, which is paramount in the protection, and for the safety of the Service Users. Individual records are secure and in good order. A new type accident book has been obtained. An electrical wiring certificate is in place. Fire equipment is tested, recorded and serviced. Valid insurance was displayed within the office. Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Durrant Care Services Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 4 2 x 2 3 x H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 5 Regulation 5 Requirement Service User agreements to be agreed and signed by them (previous timescale 30/7/05 not met) Review medication system and address concerns highlighted in text of report Timescale for action 30th September 2005 30th September 2005 2. 20 13(2) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6 Good Practice Recommendations Care plans to cover all areas of 2.3, contain any restrictions of freedom and choice, a record of goals and evidence Service User involvement (outstanding from previous inspection) Review risk assessments to ensure there is sufficient detail to actually minimise the risk and are clear as to who is responsible for actions (Service User/staff) (outstanding from previous inspection) 2. 9 Durrant Care Services H56-H05 S64523 Durrant Care Services V239198 160905 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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